Lifelong itchy spot (non skin related) on my Frenchie

My Frenchie has itched behind his right ear/right side of his neck for as long as I can remember. He’s been doing this since he was a puppy (he’s 7 now). Have had his skin tested, has clean ears, no visible spots.  It occurs several times a day and I can tell it bothers him would love help with getting to the bottom of it! He’s also very sensitive to being scratched there and can only tolerate it for a few seconds as he (seemingly) gets overwhelmed with it. He scratches it when at home/no noticeable prompt or reason as well as when excited/out in public on walks or getting attention from strangers…but always the exact same spot. Which makes me think it’s neurological or something. Any thoughts or similar experiences??!! TYIA!

Hello - What has the skin been tested for?  We test the skin for relatively little in the veterinary profession - demodex (deep skin scrape) and tumours (biopsy), for example -  but those don't generally itch.  Itchy mites and fleas are generally ruled out by treatment trial because only quite severe cases of fleas and mites are obvious from looking at the patient.  Yeast overgrowth is usually identifiable.  Other common causes of itching include pain (headaches?) and neurological oddities, as well as habit.  I suppose that your vet might be considering two questions:  1:  Is the behaviour likely to reflect underlying pain / tumour / other conditions, in which case they will want to get to the bottom of it - perhaps with a pain-killer treatment trial, neurological test or  MRI for example - and 2: Is the itching causing secondary harm - e.g. serous skin damage?  Of course some animals, like some people, may simply scratch out of habit, but your vet who knows the specifics eg what tests they have carried out so far, is the best person to outline what is a) likely and b) yet to be ruled out.  Good questions include, 'What is on the differentials (possibilities) list for an itchy ear? What have you ruled out?  What would you still like to rule out?  How urgent is this?' and to take it from there.

PS. I have not mentioned skin allergies because you say that there is no skin problem, but I am confused as to how this has been ruled out.  Skin allergies are a frequent cause of ear-itching in Frenchies and are difficult to 'test for' (not sure what tests have been done) so this may reman a differential - it's something to ask your vet about.